Asiye Uzun’s research while affiliated with Istanbul Medipol University and other places

This study aims to determine if mean platelet volume (MPV) can predict maternal and fetal outcomes in pregnant women during their third trimester. A retrospective case-control study was conducted at Medipol Hospital's Obstetrics and Gynecology Clinic, involving 200 women with gestational diabetes mellitus (GDM) and 200 healthy pregnant women. Data collected included age, gestational age, body mass index (BMI), and complete blood count parameters such as hemoglobin, hematocrit, thrombocyte count, and MPV values. The results indicated that the GDM group had significantly higher age, BMI, cesarean rates, and MPV values compared to the healthy group. Maternal complications like preeclampsia, preterm labor, shoulder dystocia, and fetal growth restriction were more frequent in the GDM group. Neonatal complications, including hyperbilirubinemia, hypoglycemia, transient tachypnea of the newborn (TTN), and increased admissions to the neonatal intensive care unit, were also significantly higher. A notable finding was the significant association between elevated maternal MPV values and the occurrence of TTN in newborns (p=0.043). Mothers of infants with TTN had higher third-trimester MPV values. Receiver operating characteristic (ROC) curve analysis established a cut-off MPV value of >11.35 ft for predicting TTN. The study concludes that elevated MPV in women with GDM is strongly associated with an increased risk of TTN in their newborns. MPV, being a simple and cost-effective parameter obtained from routine blood counts, could serve as a predictive marker for TTN. However, due to limitations such as the retrospective design and single-center data, further multi-center cohort studies are recommended to validate these findings and establish MPV as a reliable predictor for adverse neonatal outcomes in GDM pregnancies.

Aim: This study aims to evaluate the risk conditions for postpartum depression in mothers who gave birth during the COVID-19 pandemic and identify the factors influencing these conditions. Methods: A total of 642 mothers who gave birth between March 10 and May 15, 2020, were included. Data were collected through phone interviews using a sociodemographic questionnaire and the Edinburgh Postnatal Depression Scale. Participants were categorized into risky and non-risky groups based on their Edinburgh Postnatal Depression Scale scores. Statistical analyses, including student-t tests, Mann–Whitney U tests, and Pearson/Spearman correlation analyses, were performed using SPSS version 22.0. Results: The mean age of participants was 29.93±5.03 years. The prevalence of postpartum depression risk was 14.5%. Statistically significant correlations were found between Edinburgh Postnatal Depression Scale scores and factors such as educational background, history of mental illness in the family or self, birth week, delivery method, and postpartum follow-up attendance. High-risk factors included higher education, employment, higher income, cesarean section delivery, preterm birth, and feelings of inadequacy in baby care. Conclusion: The COVID-19 pandemic has increased the risk of postpartum depression. Early diagnosis and initiating treatment in mothers prone to postpartum depression can minimize negative outcomes. Identifying risk factors facilitates close follow-up and targeted preventive measures, underscoring the critical role of comprehensive care approaches in family medicine, especially during global health crises. Keywords: anxiety, pandemics, postpartum depression, pregnancy, Sars-Cov-2

Aim: Approximately one million people in the world are exposed to urogenital tract infections every year and at least 75% of women have a history of genital infection. The frequency of vaginal infections in women aged 15-49 in Turkey is known to be 35-68%. Genital infections can be asymptomatic and can cause negativity in sexual and family life. Therefore, it is important to take preventive measures. Mentioning correct genital hygiene behaviors in the training and consultancy services provided by healthcare professionals helps people to increase their awareness. In our study, we aimed to evaluate women's genital hygiene behaviors and related factors. Methods: Our study was carried out with 457 women between the ages of 15-49 in the Gynecology Outpatient Clinic of Nisa Hospital. The socio-demographic characteristics and gynecological characteristics of the subjects were collected by face-to-face interviews using the questionnaire form that consisted of 20 questions and the “Genital Hygiene Behavior Inventory”. The IBM SPSS version 22 program was used for statistical analysis. Results: This study was conducted with 457 women. A significant negative correlation was found between the Genital Hygiene Behavior Inventory score and the number of pregnancies and number of children (p=0.028, r=-0.128, p=0.037, r=-0.128, respectively), and a significant positive correlation was found between education status, income status, and having children (p=0.010, p=0.000, p=0.007, respectively). Participants who stated that they had the knowledge and received this information from doctors and/or nurses had higher Genital Hygiene Behavior Inventory scores. Conclusion: Questioning genital complaints of women by all healthcare professionals, determining hygiene behaviors, and correcting erroneous practices will positively affect urogenital health.

This study aims to evaluate the use of alternative and complementary therapies and conception status of women receiving infertility treatment. A total of 349 patients who applied to the infertility department of Medipol University and Private Nisa Hospital between October 1st and November 30th, 2020 were included in the study on their consent in participating in the research. Data was collected through face-to-face interviews using an information form prepared in accordance with the literature review carried out by the researchers. The pregnancy status of the patients was recorded as a result of the treatment and their relationship with the use of alternative and complementary therapies was examined. Of the 349 patients who participated in the study. A statistically significant difference (p [Med-Science 2021; 10(2.000): 564-70]

Background: COVID-19 pandemic has certainly become the most important global problem. Deficient information may increase the fear of COVID-19, affect pregnant women's psychology, and even affect breastfeeding during the postpartum period. This study aimed to assess the fear of the COVID-19 pandemic after pregnancy and its association with breastfeeding. Methods: A cross-sectional study designed to survey all pregnant women who gave birth at ≥36 weeks between March 10 and June 10, 2020, at the Private Nisa Hospital, Istanbul, Turkey. Participants respond to questions related to sociodemographic, genealogical, pregnancy, birth information, postpartum baby care, and breastfeeding status, in addition to the 7-item Fear of COVID-19 Scale (fcv-19s) via phone. Descriptive, bivariate, and linear regression analysis was performed to predict fcv-19s. SPSS version 22.0 was used to analyze the data. Results: A total of 906 (response rate 78.8%) respondents with a mean age of 29.59 (±4.74years) were included in the study. Most of them were highly educated (75.2%), housewives(86.1%), and living in nuclear families (96.1%). The majority of women (92.9%) gave birth at 38 weeks via cesarean section (71.7%) and breastfeeding (94.2%). Although the mean score of (fcv-19s) was high in non-breastfeeding mothers, no significant correlation was seen in bivariate analysis. In the linear regression analysis, the highly educated, good income status, having at least once follow-up a month, having a history of psychiatric disease, cesarean section delivery, competence in baby care, breastfeeding, and milk adequacy significantly predicted the (fcv-19s) (R = 0.67, R2 = 0.46, F = 42.10, p < 0.001). Conclusions: During pandemics, including COVID-19, the psychological state of society is negatively affected, and therefore special attention must be given to the most affected groups, especially pregnant and postpartum women.

Background/Aim: Most women who have completed childbearing request tubal ligation, as it is an effective and irreversible form of contraception. Single incision laparoscopic surgery (SILS) which is currently standard in most surgical specialties, eliminates multiple port incisions and provides faster recovery with better cosmesis. However, there is less data about single incision laparoscopic bilateral tubal ligation. We aimed to compare the results of single-incision-two port laparoscopic tubal ligation and conventional three port laparoscopic tubal ligation. Methods: Patients who desired tubal ligation procedure as a contraceptive method were randomly allocated to two groups as single-incision-two port laparoscopic tubal ligation (Group 1) and conventional three port laparoscopic tubal ligation (Group 2) between April 2015 to January 2020 in the Obstetrics and Gynecology clinics of two university hospitals. A prospective comparative study was conducted, and sixty patients were included in each group, which were compared in terms of operation time, blood loss, length of hospital stay, complications, port site hernia, postoperative pain score, conversion rate, cosmesis and failure of sterilization. Results: There was no need to convert to open surgery in either group. Average blood loss was similar between the groups (107.6 ml vs 98.4 ml, P=0.14). Operating time was significantly longer in group 2 compared to group 1 (38 minutes vs. 26 minutes, P=0.02). Higher pain scores were observed in group 2 compared to group 1 at the 24th postoperative hour (2.21 vs 3.82, P=0.012). Patients in group 1 were more satisfied with the single incision in the umbilicus based on cosmetic outcome scores (4.88 vs 3.16, P=0.018). There were no reported intraoperative complications in either group. No port site hernias and failure of sterilization were observed in any of the patients. All patients were followed up for a mean of 19 months (range: 12–60 months). Conclusion: Single incision two port laparoscopic tubal ligation does not increase the risk of complications and appears safe. It provides better cosmetic outcomes and lower pain scores compared to conventional laparoscopy.

Background/Aim: Non-classic congenital adrenal hyperplasia (CAH) is a milder form of CAH. The CYP21A2 gene is involved in the etiopathogenesis of both severe (classic) and mild (non-classic) form CAH, however, genetic mutations in non-classic CAH result in less impairment of 21-hydroxylase activity. Therefore, as in classic CAH, patients with non-classical CAH have no signs and symptoms of cortisol deficiency. Instead, there may be signs of hyperandrogenism that can appear later in childhood or in early adulthood. Due to excess androgenic effect on clitoris, labia minora, majora and the vagina, feminizing genitoplasty should be performed to make gender identities consistent and reshape the proper genital anatomy for sexual intercourse. However, there are few studies and controversy on feminizing genitoplasty procedures in adulthood. In this study, we aimed to design a new procedure to spare the nerves of the clitoris as well as the clitoral body, along with the cavernous tissue. Methods: This is a case series of nine patients with a mean age of 24.8 years diagnosed with non-classic CAH who underwent feminizing genitoplasty, in which nerve-sparing clitoroplasty was performed with corporal septum excision by ventral approach. Initially, diagnostic cystoscopy was performed to detect the level of vaginal confluence into the urogenital sinus. The enlarged clitoris was degloved from 10 mm proximal to the glans up to the symphysis pubis. Corporal septum was excised from the ventral part of the clitoris up to the bifurcation of crura. Neurovascular bundle was preserved completely dorsally, and the clitoris was folded over itself and fixed at the level of crural bifurcation at 3 and 9 o'clock positions. Degloved clitoral preputium was used as Byars’ flaps for labiaplasty. A perineal inverted U incision was made and the vaginal introitus was enlarged with this flap. Female Genital Image Scale (FGIS) was used in the assessment of patients’ postoperative genital self-image. Results: Feminizing genitoplasty (nerve-sparing clitoroplasty with corporal septum excision, labiaplasty and perineal flap vaginoplasty) was performed in nine patients diagnosed with non-classic CAH. The mean operation time was 112 minutes with a range of 90-140 minutes. Urogenital sinus mobilization was not performed as the vaginal confluence into urogenital sinus was low in cystoscopy. Patients were re-assessed at 1 month, 3 months and 6 months postoperatively. FGIS scores showed that four patients were “very satisfied,” one patient was “satisfied,” 2 patients were “moderately satisfied”, and one patient was “dissatisfied.” The maximum follow up was 2 years with no recorded short or long-term complications. Conclusion: Nerve sparing clitoroplasty with corporal septum excision is a good option with satisfactory long term results for non-classic CAH patients. However, we need many more comparative studies to decide the gold standard method for optimal physiologic and cosmetic outcomes in CAH patients.

The human X-box binding protein 1 is a transcription factor that is expressed by cellular oxidative stress. We aimed to analyze the relationship between early pregnancy loss and maternal blood X-box binding protein 1 levels. Patients who presented to our Obstetrics and Gynecology clinic between October 2019 and February 2020 were included in this study. Patients were divided into two groups: Group 1 included healthy pregnant women and Group 2 included patients who were diagnosed with missed abortion. First, blood samples were taken from the patients in group 2 when they were diagnosed with missed abortion. While evaluating the patients in group 1, the average gestational weeks of the patients in group 1 were calculated and blood samples were taken between the same weeks. Next, patients with healthy pregnancy in group 1 were followed up prospectively and double screening test were performed at the perinatology outpatient clinic at the end of the 1st trimester, and the blood results of the patients with normal results were evaluated. Blood samples extracted from these patients were centrifuged at −80 °C and stored until analyses. Serum X-box binding protein 1 levels were measured using enzyme-linked immunosorbent assay kits (Cusabio, Wuhan, China). Eighty-five patients were included in this study: 42 in Group 1 and 43 in Group 2. There was no difference between the groups in terms of age, body mass index, ethnicity, and systemic illness. Serum X-box binding protein 1 levels were significantly higher in Group 2 (129.89 ± 7.58 ng/L) than in Group 1 (119.56 ± 5.99 ng/L) (p < 0.001). Serum X-box binding protein 1 levels higher than the cut-off value of 119.05 ng/L were associated with a higher risk of early pregnancy loss. Serum X-box binding protein 1 levels may be used to predict early pregnancy loss; however, additional comparative studies are required to confirm this result